Inspection on 02/06/05 for The Beeches

This inspection was carried out on 2nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Beeches 17/11/08

The Beeches 22/11/07

The Beeches 18/12/06

The Beeches 30/11/05

The Beeches 06/07/04

The Beeches 27/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 The Beeches Frodingham Road Brandesburton East Yorkshire HU25 8QY Lead Inspector Lynne Busby Unannounced 2 June 2005 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Beeches Address Frodingham Road Brandesburton Nr Driffield East Yorkshire YO25 8QY 01964 542459 01262 424563 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr John Charles Kunning Susan Melvin Care Home 11 Category(ies) of LD Learning Disability (11) registration, with number of places The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20/01/05 Brief Description of the Service: The Beeches is a care home providing care and accommodation for up to 11 people under the age of sixity five who have learning difficulties. The home is located on one of the exit roads from the village of Brandsburton. It is close to local amenities and within easy access to public transport. The home has been registered for a number of years and is a two-storey buiding. It was previously part of the local hospital for people with learning difficulties. There are 11 single rooms all without en-suite facilities. One room does have a shower. There are 4 toilets and 3 bathrooms available. The home has a good sized garden and is surrounded by countryside. There is a car park at the front and rear of the property. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was completed as part of the programme of inspections for the year. It was an unannounced inspection undertaken by one inspector. The inspection day lasted from 9.00 am to 4.00 pm with two hours preparation time being completed before the inspection. The inspection process included a review of documentation and a tour of the building. The inspector spoke to three of the staff on duty, the provider, five of the ten residents, and a visiting health professional. What the service does well: What has improved since the last inspection? What they could do better: There is always two staff on duty but this does not fully meet the needs of the residents. Staff must be employed correctly and in sufficient numbers so that people living in the home are protected. There is a maintenance programme available. The home offers comfortable furnishings but requires some redecoration in the communal areas and in some of the bedrooms. The kitchen requires updating. The inspector did not have access to the staff records at this inspection and therefore could not assess if progress had been made with regard to the recruitment and selection of staff. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 5 The assessment and statement of terms and conditions of service users fully meets their needs. EVIDENCE: The service users are only admitted to the home following a full assessment. In the files tracked there were copies of the Care Management Assessment. At the present time the home do not have any service users who are self-funding. However, the provider informed the inspector that the home has a needs assessment available. The home develops a plan of care from the care management assessment and care plan. Risk assessments are in place and any restrictions to the service users’ choice and freedom, services or facilities are clearly documented. Service users are provided with a contract/statement of terms and conditions. The provider advised this is explained to the service user. Service users have a copy of the contract and the service user signs this. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 7 The service users are consulted on, and participate in all aspects of the life in the home. Individual care plans and records did not consistently identify how service users needs are met. EVIDENCE: The inspector tracked three service users files and all had copies of care plans that had been updated and amended to ensure service users receive appropriate care to meet their needs. At the previous inspection it was identified that one service user receives funding for 1 to 1 care during the day. There was no written evidence to indicate how this service user benefited from this care or what activities he had participated in during this time. This was discussed with the provider previously and this was still not being recorded. Risk assessments were seen for activities of daily living. Risk management plans were seen in some care plans for challenging behaviour and inappropriate behaviour. A variety of specialists have input including psychiatrists, CPN and CTLD and this was recorded in service users individual files. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 10 The service users have signed their care plans, but there was no evidence to indicate their family, friends or advocate have been given the opportunity to support the individual during this process. The provider said that he is aware that this needs to be addressed. The inspector will assess the progress of this at the next inspection. It was identified at the last inspection that staff needed to develop skills in recording within the care plan, the choices made by service users and any decisions made on their behalf by the home. This is still outstanding. The plan is reviewed at least every six months. Some of the service users spoken to advised that they attended their review. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14,15 and 16 Service users can choose to take part in appropriate leisure activities in the local community. EVIDENCE: The service users have access to activities outside the home. The home has a mini bus and service users had been out to the coast, swimming and the sea life centre. One service user said they went out with their family to the pub. The service users are offered a holiday as part of the basic contract. If the service users decide that they wish to have a different holiday to that offered, they pay for this themselves. A number of the service users were excited about their forthcoming holidays. Some were going to Rome, others were going to Disneyland Paris and one service user said they had chosen to go to Butlins. The day-to-day routines of the home promote independence. One service user told the inspector that they like to do their own ironing. Another service user likes to help with the cooking. The interaction between the staff and the service users was observed to be relaxed and staff communicated effectively. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 12 On the day of the inspection it was observed that service users have unrestricted access to the home and grounds. The service users choose when to be alone or in company. A service user informed the inspector that family and friends are welcome in the home and can see them in the lounge or in private. Service user can develop intimate relationships with people of their choice. There was evidence that service users are supported to continue with day centres, college and work placements. One service user has a work placement in the local community. Service users are encouraged and supported to be integrated into community life. The registered provider advised the inspector that the home had a good relationship with neighbours and the local community. There is local transport available and during the inspection one service user went into the local town to visit the shops and have lunch. Staff advised the inspector that staff time is flexible when supporting service users and staff will stay to assist service users after the end of their shift. This needs to be reflected on the staff rota (see staffing). The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 The physical and emotional health needs of service users are met. EVIDENCE: Service users had recently been shopping for new clothes for their holidays and these reflected their personality. Personal support is provided in private by staff of the same gender where possible. The care plans document the input individuals receive from specialist support services such as CTLD, CPN and other professionals who are involved in their care. The inspector spoke to a visiting health professional who advised “ the staff are very supportive and open to suggestions to work with service users”. The health care of the service users is promoted. A service user informed the inspector that staff would go with them to health appointments. All service users are registered with a local GP and have good access to the community health team. All the service users have a keyworker and those spoken to by the inspector knew who their keyworker was. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 14 The medication was not assessed at this inspection. However, there was an outstanding recommendation from the previous inspection regarding the medication policy and this has not been changed. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The service users are listened to and protected. EVIDENCE: The home has a complaints procedure available. There have been no recent complaints made at the home. There is a system in place for recording details of any investigation, action taken and outcome. The service users are aware of how to make a complaint. One-service user told the inspector “ I know how to make a complaint “ and explained they would go to the provider. The home has a copy of the Hull and East Riding Protection of Vulnerable Adults procedure and has developed in house policies. Some of the staff have attended training on Protection of Vulnerable Adults and are aware of their role and responsibilities in ensuring service users are safe and protected from abuse. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 Service users live in a comfortable environment and the home is clean and hygienic. EVIDENCE: The provider advised that there is a maintenance programme available. The internal decoration is ongoing and some of the communal areas (particularly the hallway) and some service users rooms require redecoration. The kitchen unit doors have not been replaced; this was identified at a previous inspection and the visit from the environmental health officer also recommended that these be replaced. The home is clean and hygienic. There is an adequate laundry facility, which includes a new washing machine. The laundry is washed at appropriate temperatures. Some of the service users are supported by staff to do their own laundry. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33,34, 35 and 36 Service users are supported by an effective team. The procedures and practices of recruitment and selection of staff are not followed and this does not fully protect people living in the home. EVIDENCE: The home have no staff that have completed NVQ level 2 training. This was discussed with the provider who advised that some of the staff are to start this training in the near future. It was identified at a previous inspection that records identified an element of bullying from some service users. There was a recommendation that staff undertake training in this area. Staff informed the inspector that they had attended training in challenging behaviour and bullying was covered during this session. The staffing rota was available for inspection. Since the previous inspection there has been the addition of one part time staff member. This does not fully cover the shortfall of the 44 hours per week identified in previous reports or that one service user is funded for 1-1 care during the daytime. This is not reflected in the hours seen on the rota. There must be enough staff on duty at all times to meet the needs of service users. Staff informed the inspector that The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 18 they often help by staying on to cover taking service users to health appointments. This was not reflected on the rota. The provider advised the inspector that they were actively recruiting staff but it was difficult to recruit at present. The present staffing includes two staff who sleep in at night. This means that staff are reliant on service users alerting them if there is a problem. It was identified at the last inspection that one service user is on specific rules regarding not leaving the home unaccompanied. The registered provider must be able to evidence the safety issues are in place. The home has regular staff meetings and one took place on the day of the inspection. The inspector was not able to access the files on recruitment or supervision as they were locked away in the drawer and the key was not on the premises. As access was not available at the last inspection these must be available at the next inspection. There is a training and development plan available. The staff have attended a challenging behaviour course, health and safety, emergency first aid and incontinence training. There is still no progress in the staff using the Learning Disability Award Framework training to provide underpinning knowledge for progress towards NVQs. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,40,41,42 The home is well managed and service users health, safety and welfare and rights and best interests are safeguarded by the policies and procedures. The home is not fully audited through a quality assurance system to ensure service users needs are met. EVIDENCE: The registered manager attends periodic training to maintain her skills. She has recently been awarded the NVQ level 4 in care and management. The home is still developing an effective quality assurance system. The policies and procedures are reviewed and updated. Staff can access up to date copies of policies and staff have signed to indicate they have read the policies and procedures. Service users have access to their records and this information is in the homes statement of purpose. All records are held safe and secure. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 20 The registered provider ensures safe working practices. Moving and handling, food hygiene and fire training have all been provided. Information on infection control and understanding and practice of measures to prevent the spread of infection and communicable diseases has been provided to staff in policy form. Maintenance certificates were available for inspection. Risk assessments are carried out and documented and all accidents are recorded and reported. Fire equipment has been checked. There was no evidence of a fire risk assessment this was to be forwarded to CSCI . There was evidence of weekly fire alarm checks since 17/03/05. Fire evacuation was last held on the 16/05/05. Water tempertures must be based on assessment and capabilities of the service users. The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 1 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x 2 1 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Beeches Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 1 3 1 1 x J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 6 Regulation 14 Requirement The registered provider must ensure that the care plan covers all aspects of care including 1-1 input. (Previous requirement timescale 1/05/05 - not met). The registered person must ensure staff can demonstrate how individual choices have been made; and record instances when others have made decisions and why. (Previous requirement - timescale 1/05/05 - not met). The registered person must ensure that kitchen units have replacement doors. (Previous requirement - timescale 1/05/05 - not met). Redecoration to be completed in commual areas and some bedrooms. The weekly fire alarm checks and emergency lighting checks must be kept up to date. The registered person must ensure that the home has an effective staff team, with sufficient numbers and complimentary skills to support service users assessed needs at all times. (Previous requirement Timescale for action 18/07/05 2. 7 12 31/07/05 3. 24 13,23,39 30/11/05 4. 5. 6. 24 24 33 23 23 18 (1)(a) 30/11/05 18/07/05 31/07/05 The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 23 - timescale 1/05/05 - not met). 7. 39 10,12,15, 24 The registered person must ensure an effective and efficient quality assurance and quality monitoring system is in place. (Previous requirement timescale 1/05/05 - not met). The registered person must ensure that records required by regulation and for the protection of service users and for effective and efficient running of the business are maintained, up to date and accurate. (Previous requirement - timescale 1/05/05 - not met). The registered provider must ensure the regulation water temperatures is based on assessment of the capabilities and needs of service users (i.e temperature close to 43C). 30/09/05 8. 41 17,37 30/07/05 9. 42 16 31/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 20 Good Practice Recommendations The medication policy and procedure should be updated to include information and guidance for staff around the noncompliance by a service user regarding the taking of medication. 50 of care staff should have achieved an NVQ 2 qualification by the end of 2005. The registered person should ensure staff working in learning disabilities service use the Learning Disability Award Framework - acredited training to provide underpinning knowledge for progress towards achieving NVQs. (Previous requirement - timescale 1/05/05 - not met). 2. 3. 32 35 The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Beeches J53_s19735_The Beeches_v226779_020605_Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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